Diagnostic value of 3D T1-weighted gradient-echo and 2D T1-weighted in-phase and out-of-phase gradient-echo sequences for appendicitis diagnosis in pregnant women

Abstract

Objectives: This study compared the diagnostic value of 3D T1-weighted (T1W) gradient-echo (GRE) and 2D T1W in-phase and out-of-phase GRE sequences for appendicitis diagnosis in pregnant women. Material and Methods: This retrospective study included 25 pregnant patients with suspected appendicitis who underwent 1.5 Tesla abdominal magnetic resonance imaging and had definitive diagnoses. Four doctors approached four separate imaging groups: A (only T2-weighted image [T2WI] sequences), B (T2WI and 3D T1W GRE sequences), C (T2WI and T1W in-phase and out-of-phase GRE sequences), and D (T2WI, 3D T1W GRE, and T1W in-phase and out-of-phase GRE sequences). The kappa (κ) index was used to compare the appendicitis diagnostic results between groups. The diagnostic value of these sequences in the diagnosis of pregnancy appendicitis was also evaluated. Results: Groups A and C had average consistency with definitive diagnosis (κ = 0.6), lower than Groups B and D (κ = 0.865), indicating a high definite diagnosis consistency. Groups B and D had similarly high sensitivity (80%), specificity (100%), positive predictive value (100%), negative predictive value (95.2%), and accuracy (ACC) (96%), higher than Groups A and C (60%, 95%, 75%, 90.5%, and 88%, respectively). Conclusion: 3D T1W-GRE sequences improve appendicitis diagnosis in pregnancy compared to T2W sequences alone. Adding in and out phase GRE sequences do not increase diagnostic ACC.